Thinking about Drinking: A Year in the Life of an Alcohol Researcher at Stirling

Niamh was active in helping the media understand the implications of theniamhfitzgerald 2016 new alcohol guidelines. In this blog post she discusses what happened as a result of the publication of the new guidelines and how the media portray the facts in their own way.

By Niamh Fitzgerald, Research Profile, @NiamhCreate

Journalists love a good alcohol story, especially at this time of year, and January 2016 gave them the ideal ammunition with the publication of new advice from the UK’s Chief Medical Officers (CMOs) designed to provide people with ‘accurate information and clear advice about alcohol and its health risks’.  For the first time, the guidance advised that ‘no level of regular drinking can be considered completely safe’ and advised the same limit for both men and women – not to regularly drink above 14 units of alcohol (about 1 and a half bottles of wine) per week, at the same time moving away from the previous daily limits.  The guidance was based on a lengthy process involving experts from around the UK including Prof. Gerard Hastings (from Stirling) and followed emerging evidence on the links between alcohol and cancer – kicking off a furore of media coverage.

Media coverage following the publication of the new guidelines

The Daily Mail led with the news that the guidelines would ‘put a stop to the belief that red wine is good for you in moderation, while the Sun also focused on this ‘plonk lovers’ shock’ as the CMO’s ‘rubbished’ the supposed health benefits of wine.

alcohol-daily-mail

Others focused on the cancer risk, with the Scotsman leading with ‘drinkers at risk of cancer from single glass of wine’; whereas the Telegraph headline was ‘health chiefs attacked for nanny state alcohol guidelines’.  It was a frantic week for colleagues and I at the Institute for Social Marketing (ISM) as we sought to capture all of the newspaper, television and radio coverage for future analysis.  As Lecturer in Alcohol Studies at ISM, and lead for teaching and public engagement on alcohol for the UK Centre for Tobacco and Alcohol Studies (UKCTAS), I was interviewed about the new guidelines on BBC News for their ‘Ask This’ feature, which takes questions from viewers.  I also had a comment piece published in The Scotsman. Continue reading

Experts say WHO needs better understanding of the evidence on e-cigs to inform its international tobacco control treaty.

A new WHO report fails to properly evaluate the evidence on e-cigarettes and could even undermine international efforts to reduce smoking, says a group of UK based academics.

UK academics are calling for better understanding of the potential benefits of e-cigarettes to reducing the smoking pandemic ahead of an international gathering of countries that have signed the World Health Organisation’s Framework Convention for Tobacco Control.

The 7th session of the Conference of the Parties (COP) of the Framework Convention on Tobacco Control (FCTC), a global public health treaty, will be held in Delhi, India from 7th-12th November 2016. At this meeting, Parties to the treaty (countries and other jurisdictions) will discuss whether similar policy measures recommended to reduce tobacco use should be applied to e-cigarettes.

In advance of the COP the World Health Organisation published a report about Electronic Nicotine Delivery Systems (ENDS) and Electronic Non-Nicotine Delivery Systems (ENDDS), also known as e-cigarettes. This aimed to summarise the evidence about these devices.

Academics from the UK Centre for Tobacco and Alcohol Studies, a UKCRC Public Health Research Centre of Excellence, have today published a robust critique of the WHO report setting out a series of concerns about the content of the document which, in their view, screen-shot-2016-10-26-at-12-37-14does not fairly represent existing evidence on e-cigarettes. Their critique examines each element of the WHO report and identifies flaws in the way the evidence is presented and problems with how the report could be interpreted, potentially encouraging countries to adopt excessive restrictions on e-cigarettes which could undermine efforts to reduce smoking.

The UKCTAS critique points to evidence set out in the recent Royal College of Physician’s’ report ‘Nicotine without Smoke’ and subsequent research which recognise that e-cigarettes are far less harmful than smoking and that smokers who find it difficult to stop should be encouraged to use them.

The WHO report fails to accurately present what is already known about e-cigarettes. In particular, it: positions e-cigarettes as a threat rather than an opportunity to reduce smoking; fails to accurately quantify any risks of e-cigarettes compared with smoking; misrepresents existing evidence about any harms to bystanders; discounts the fact that e-cigarettes are helping smokers to quit; does not recognise the place of some promotion of e-cigarettes to encourage smokers to switch to these less harmful products; fails to understand that the flavours in e-cigarettes are useful for people trying to stop smoking; mischaracterises the current e-cigarette market screen-shot-2016-10-26-at-12-39-18and appears to support very restrictive policies on e-cigarettes without including any good policy analysis. In addition, the WHO report does not acknowledge that significant restrictions on e-cigarettes could lead to unintended consequences, including increases in smoking.

Finally, the researchers point out that the WHO briefing is based on four unpublished papers which are still undergoing peer review, which does not allow for open, transparent scrutiny of the evidence. This does not, therefore, provide a good basis for policy making and risks undermining rather than promoting the aims of the FCTC, which is a treaty that was designed to help countries reduce smoking rates and save lives.

To read the full report click here.

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Prescribed alcohol drug ‘Nalmefene’ was licensed despite insufficient evidence to prove its effectiveness

A study from the University of Stirling’s Institute of Social Marketing showed that a drug being used to treat alcohol problems in the UK was licensed for use, despite insufficient evidence to prove its effectiveness.

The drug nalmefene, marketed as Selincro®, was approved in Europe in February 2013 and was subsequently recommended by the UK National Institute for Health and Care Excellence (NICE).

Yet a team of scientists have found problems with the way clinical trials were conducted and analysed, making it impossible to know how much the drug actually helps to reduce drinking in patients dependent on alcohol.

Outlined in the journal Addiction, a group of experts analysed the published studies of nalmefene that formed the basis for the licensing and NICE decision. They concluded that evidence of its effectiveness was weak, and any possible effect on patients was small at around a one drink per day reduction on average. Continue reading

Novel ways of using tobacco packaging to deter smoking – University of Stirling – PhD opportunity

About This Project

Packaging is an important marketing tool for tobacco companies, helping to capture attention, create brand awareness, foster positive brand attitudes and communicate product attributes. For smokers, the pack is their personal choice, a statement of their identity, something that stays with them wherever they go and something that it is typically seen countless times a day. The pack turns a generic product into a bespoke marque. Even for non-smokers, tobacco packaging is a familiar feature of life, whether within shops, as litter or in the hands of smoking friends and relatives. It is unsurprising, then, that tobacco companies have been very creative in their use of all elements of the pack – colour, shape and design, the cellophane wrapper, inserts, and the cigarette itself – to communicate the positive qualities of the product and the brand.

SP-TPDMock_upLoresGovernments have also recognised the importance of packaging as a communications tool. Health warnings, for instance, first appeared on cigarette packs almost half a century ago in the UK, and over time have increased in size and now include pictures. These warnings are a cost-effective and credible means of informing of the health risks of smoking. From May 2017 standardised packaging will be implemented, which will essentially leave all packs looking the same and make the health warnings stand out even more.

Much more could still be done with the packaging however. For instance, pack inserts are an inexpensive means of communication, and have been widely used by tobacco companies. Could the use of inserts, with positively framed messages encouraging smokers to quit and promoting self-efficacy to do so, be of value within the UK? There is also the cigarette itself, which tobacco industry journals refer to as an increasingly important promotional tool. While at a very early stage, academics have begun to explore the possibility of using the appearance of the cigarette to deter smoking, for instance unattractively coloured cigarettes or cigarettes displaying health warnings. Further research exploring these ideas, or the many other potential ways to reduce the appeal of cigarettes, would be of significant value.

There are likely many other possibilities of using the pack to discourage non-smokers from starting and encourage smokers to stop. Supposing, for example, the pack had an audio warning when it was opened? Or it featured a Quick Response barcode on the pack that could direct smartphone users to a stop-smoking service, or similar innovations using barcodes, like augmented reality, which could direct the user to social networking campaigns. The options are many and varied. As the Scottish Government has set a target date for reducing smoking prevalence to less than 5% of the population, and packaging is seen as a crucial platform for health promotion, this PhD could help generate ideas that could help reach this target.

This PhD would have two key objectives:
• To explore the range of possible health promoting packaging innovations, and
• To explore how consumers respond to some of these measures.

For More information and to apply for this PhD click here.

#WorldNoTobaccoDay: Linda Bauld and the road to standardised tobacco packaging @bmj_latest

“The road to standardised tobacco packaging in the UK”

Every year in the United Kingdom around 200 000 children start smoking. Half of those who try a cigarette will become regular smokers, putting themselves at risk of tobacco related diseases that can shorten their lifespan by at least a decade. Because of this, the UK and other governments have implemented a range of tobacco control measures over many years, which are intended to both prevent smoking uptake and encourage smoking cessation. Key among these have been measures to restrict the ability of the tobacco industry to market their products to new and existing smokers.

Firstly, traditional forms of advertising such as TV and billboards were banned, followed by sports sponsorship, and, most recently, point of sale displays in shops. All that was left was tobacco packaging: a way to communicate to consumers the appeal of the product and to promote different brands.

My team at the University of Stirling has conducted research on tobacco marketing for many years, funded by Cancer Research UK. Most recently we undertook our own studies on tobacco packaging, and then in 2011 were commissioned by the Department of Health to review all the evidence on plain or “standard packs.” Our review provided the basis for a UK consultation on the issue. At the time we found 37 studies, conducted in different countries and using a variety of research designs. Their findings were consistent. The studies showed that standard packs are: less appealing, increase the visibility and effectiveness of health warnings, and reduce the ability of packaging to mislead people about the harms of smoking.


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Dr Crawford Moodie [@Stirling_Health] speaking about plain packaging and E-cigs to Good Morning Scotland

The first results from Australia – which has introduced plain packaging – show that smokers found plain packaged cigarettes to be “less satisfying and poorer quality” and “were more supportive of plain packaging and more likely to think about and to prioritise quitting”.

Writing in the BMJ, three academics from the University of Stirling  – Dr Crawford Moodie, Professor Linda Bauld, and Martine Stead – ask how much more evidence is needed before the UK Government makes a decision on plain-packaged cigarettes.

Hear Crawford speaking on BBC Good Morning Scotland on 20/05/2016 below:

“Standardised packaging in the UK was first considered as a possible policy measure in the previous Labour government’s consultation on the future of tobacco control in 2008, which cited four studies from North America. By 2011, when the current government launched a consultation on the issue, its evidence review included 37 studies, six of which were from the UK. Since that review at least 12 additional studies have been published, including three more from the UK.

“This growing body of research is consistent in its findings: that plain packaging would reduce the appeal of tobacco products to consumers; would increase the effectiveness of health warnings; and would reduce the ability of packaging to mislead consumers about the harmful effects of smoking.” Continue reading